Zombie Bioethics

Stanford doctors want to create human bodies without brains so they can exploit them with impunity. Here's my rejection of that gruesome proposal.

The following was published recently in First Things and is reprinted here with permission.

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A recent article in MIT Technology Review carries the strange ­title, “Ethically sourced ‘spare’ human bodies could revolutionize medicine.” Three Stanford biologists and ethicists argue for the use of so-called bodyoids in science and medicine. This infelicitous term refers to hypothetical modified human bodies created from stem cells—bodies that have been genetically altered so that they lack brains, and thus, presumably, are without consciousness. The authors acknowledge that we do not yet have the technical capability to create such beings, but recent advances in stem cells, gene editing, and artificial uteruses “provide a pathway to producing living human bodies without the neural components that allow us to think, be aware, or feel pain.”

Strictly speaking, artificial uteruses are not necessary for the development of bodyoids. Such a reprogrammed embryo could ­theoretically be created in a lab and implanted in a woman’s uterus, as is done with IVF. But the notion that an entity regarded as subhuman should be born from a human mother seems too gruesome even for these bioethical pioneers to contemplate.

The authors admit that many will find the prospect of bodyoids disturbing, but they argue that a “potentially unlimited source” of “spare” human bodies will be immensely useful and should be pursued. We could, for example, harvest the organs of these ­presumably nonsentient humans and conduct experiments on them in order to test drugs and other medical interventions. The authors even suggest that it would be more ethical to do drug testing on humans who cannot feel pain, because they lack nervous systems, than on animals that can feel pain. There are other potential benefits for animal species as well, they aver, since we could use animal bodyoids to avoid causing pain and suffering in the cows and pigs we slaughter for food.

Human bodyoids are not entirely within the realm of science fiction. Scientists have recently produced “embryoids,” or “synthetic ­embryos,” from reprogrammed stem cells, without the use of sperm and eggs. Embryoids are living entities that seem to develop as human embryos do but that presumably lack the capacity for full human development. (We do not know for sure that they do, as they are typically destroyed after fourteen days, before the heart and brain have begun to develop.) Just as advocates for embryoids argue that their innovation allows us to avoid the ethical problems associated with embryo-destructive research, so advocates for bodyoids propose to provide us with “ethically sourced ‘spare’ human bodies.”

The Christian ethicist Oliver O’Donovan described “a position too familiar to technological society, that of having achieved something that we do not know how to describe responsibly.” In the case of bodyoids, I submit, advocates do not know how to describe them at all. One can hear them stumbling over their words and fumbling with descriptors.

Bodyoids are human bodies. Or rather, human-like bodies. But not human in any morally relevant sense—they lack brains, after all. But sufficiently human that we can harvest their organs for transplant and conduct experiments on them to see how “real” humans would respond to drugs. Indeed, they are of interest to scientists precisely because they are so, well, so very human. But not really. For the most part.

Well, then, what are human bodyoids?

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Long before ethicists began to contemplate living—or at least, undead—human creatures who lack all brain function, such entities were explored in science fiction and horror films. The precise name for such a creature is zombie. The concept has roots in Haitian folklore, where the term is zonbi, referring to a person who has been brought back from the dead through magical means to serve as a mindless slave. The problem with creating zombies, our stories suggest, is that they always come back to bite us. Creating them ­diminishes our humanity.

Are not zombies precisely what advocates of bodyoids want to conjure into existence—a mindless slave, biologically and physiologically human in all relevant ways, that can nevertheless be experimented upon, harvested, and killed with impunity? Indeed, by our current definition of brain death, such an entity cannot actually be killed because it is already dead. In this, too, it resembles a zombie. One can easily imagine a B-movie horror feature titled Revenge of the Bodyoids.

The concept of brain death—­defined as total cessation of all brain function—arguably paved the way for advocates of the ­creation and exploitation of bodyoids. As the authors of the article point out, “Recently we have even begun ­using for experiments the ‘animated cadavers’ of people who have been declared legally dead, who have lost all brain function but whose other organs continue to function with mechanical assistance.” What are we to make of the term “animated cadaver,” which seems to express a manifest contradiction?

Advocates for the brain-death criterion argue that death is the disintegration of the unified organism, and the brain is responsible for maintaining organismic unity. Liberal bioethicists also argue that without consciousness, though there may be a living human being, there is no morally or legally relevant “personhood.” But these arguments do not withstand scrutiny. The brain modulates the coordinated activity of the other organs; it does not create that coordinated activity. That is accomplished by the organic formal unity of the body as a whole—which modern science, with its reductionistic analysis of the body into component parts, fails to discern.

Although a brain-dead patient has no functional electrical activity of the brain, the patient continues, with the help of machines, to breathe and to circulate blood. The organs continue functioning and remain fresh for transplant. The body of a brain-dead person on a ventilator maintains homeostasis and ­coordinated unity of functions: The kidneys make urine; the liver makes bile; the immune system fights off infections; wounds heal; hair and fingernails grow; endocrine organs secrete hormones; broken bones ­heal and broken skin repairs; children grow proportionately as they age. Pregnant mothers can even gestate babies after brain death, sometimes for months. Consider the contradictions and manifest absurdities in this headline: “Brain-dead Virginia woman dies after giving birth.”

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To all appearances, a patient in this state is not, in fact, dead. Some medical ethicists have therefore—quite sensibly—questioned the validity of “brain death” as a criterion for death. The brain-death criterion was developed by a Harvard Medical School committee in 1968 to free up ICU beds and promote organ ­transplantation—with death itself forming the foundation of the organ-transplant enterprise. For organ transplantation rests upon a paradox, perhaps an outright contradiction: a “dead” donor whose body, with its precious organs, is still living.

After a person is pronounced brain dead, if the family refuses transplantation or if the organs are deemed unsuitable for transplant, the following situations emerge. Once the ventilator is turned off, the patient’s heart may continue beating for several minutes, or even a few hours (especially if the patient is a newborn). Surely we would not send such a “dead” patient to the morgue, cremate her, or bury her while the heart still beats. Should we then give a drug, like potassium chloride, to stop the heart of the supposedly already dead patient? In some cases, we wait a day or two to shut off the machines of a patient who is pronounced brain dead, to allow family to travel and be at the bedside when the ventilator is discontinued and, eventually, the heart stops. Will the family witness the death of the patient, or merely the cessation of efforts to animate an already dead corpse? If the latter, why would family members want to be present for that?

Considering these oddities and absurdities, which stem from the legal fiction that brain death is the death of the person, “total brain failure” is a more accurate term than “brain death.” It indicates an irreversible coma, not a dead body. Perhaps such a person is “better off dead,” as many people assume. Certainly, it is ethically justifiable in such a situation, where meaningful recovery of human functioning is impossible, to discontinue life-extending measures such as ventilators or antibiotics. Even so, such a person is not yet dead.

Indeed, advocates of bodyoids, which would similarly lack all brain function, do not argue that a bodyoid is dead—merely that it is not human. Bodyoids are of interest precisely because they are living and human in all scientifically relevant respects. To their credit, the Stanford authors do mention the following danger: “Perhaps the deepest [ethical] issue is that bodyoids might diminish the human status of real people who lack consciousness or sentience”—such as those in a coma or babies born without a cerebral cortex (a severely disabling condition known as anencephaly).

However, the authors go on to dismiss this concern. They argue that, like bodyoids, a sufficiently detailed mannequin would look much like us; that does not make it human. But nobody is proposing scientific experiments on mannequins, and for good reason. However realistic they might appear, they are not human, and thus, unlike a bodyoid, they have no value for ­science and medicine.

A bodyoid’s value for science and medicine lies precisely in what it would be, which is not a zombie, not a dead person, not a mannequin that mimics the human form. It would be a profoundly disabled human being, designed and created to be profoundly ­disabled—a ­vulnerable human being so ­totally defenseless and voiceless that it could be exploited with ­impunity.

If this is the case, we would endorse this macabre project only if we ourselves had become, so to speak, moral zombies.

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